Change in Imaging Findings on Angiography-Assisted CT During Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma
Change in Imaging Findings on Angiography-Assisted CT During Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma
复制标题
肝细胞癌球囊闭塞动脉化疗栓塞术期间血管造影辅助CT影像学表现的变化
DOI：
10.1007/s00270-015-1279-9
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Awai K
中科院分区：
文献类型：
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作者：
Yoshimatsu R;Yamagami T;Ishikawa M;Kajiwara K;Aikata H;Chayama K;Awai K
目的探讨肝动脉造影（CTHA）和动脉门静脉造影（CTAP）的CT改变及其与经导管动脉化疗栓塞（B-TACE）术中肿瘤内碘油沉积的关系。评价了选择性CTHA伴/不伴球囊闭塞和B-TACE后碘油积聚的肿瘤增强。CTAP上的肿瘤性门脉灌注缺损的大小进行了比较，有/无球囊闭塞。选择性CTHA与/无球囊闭塞和碘化油积聚程度之间的差异的影响因素investigated.ResultsAmong 27个肿瘤，选择性CTHA的肿瘤增强改变后球囊闭塞14（减少，11;增加，3）。18个肿瘤中，选择性CTHA和球囊闭塞的肿瘤增强与碘化油积聚程度之间存在差异，这18个肿瘤均高于肿瘤增强等级。在20个肿瘤中的18个中，CTAP上的肿瘤性门脉灌注缺损在球囊闭塞后显著减少（平均直径从21.9 mm减少到19.1 mm;p= 0.0001）。无显著因素影响选择性CTHA伴/不伴球囊闭塞之间的差异。中心区肿瘤的位置，选择性CTHA与球囊闭塞肿瘤增强差，并没有减少在CTAP的肿瘤门灌注缺损面积后球囊闭塞显着影响穷人碘油积聚在tumor.ConclusionsTumor增强选择性CTHA经常改变后，球囊闭塞，这并不对应于积累碘油在大多数情况下。
PurposeTo evaluate changes in imaging findings on CT during hepatic arteriography (CTHA) and CT during arterial portography (CTAP) by balloon occlusion of the treated artery and their relationship with iodized oil accumulation in the tumor during balloon-occluded transcatheter arterial chemoembolization (B-TACE).MethodsBoth B-TACE and angiography-assisted CT were performed for 27 hepatocellular carcinomas. Tumor enhancement on selective CTHA with/without balloon occlusion and iodized oil accumulation after B-TACE were evaluated. Tumorous portal perfusion defect size on CTAP was compared with/without balloon occlusion. Factors influencing discrepancies between selective CTHA with/without balloon occlusion and the degree of iodized oil accumulation were investigated.ResultsAmong 27 tumors, tumor enhancement on selective CTHA changed after balloon occlusion in 14 (decreased, 11; increased, 3). In 18 tumors, there was a discrepancy between tumor enhancement on selective CTHA with balloon occlusion and the degree of accumulated iodized oil, which was higher than the tumor enhancement grade in all 18. The tumorous portal perfusion defect on CTAP significantly decreased after balloon occlusion in 18 of 20 tumors (mean decrease from 21.9 to 19.1 mm in diameter;p= 0.0001). No significant factors influenced discrepancies between selective CTHA with/without balloon occlusion. Central area tumor location, poor tumor enhancement on selective CTHA with balloon occlusion, and no decrease in the tumorous portal perfusion defect area on CTAP after balloon occlusion significantly influenced poor iodized oil accumulation in the tumor.ConclusionsTumor enhancement on selective CTHA frequently changed after balloon occlusion, which did not correspond to accumulated iodized oil in most cases.